IDR Data
CMS PUF data · 2023 Q1–2025 Q4

Federal IDR outcomes: Critical care in New Jersey

In 2025 Q1–Q4, the provider or facility offer prevailed in 96.6% of 88 determined Federal IDR dispute line items for critical care in New Jersey. The median prevailing offer was 27.45x the QPA (25th–75th percentile 6.50x–131.28x; n = 86). The median time to a decision was 26 business days (n = 88).

Determined line items

88

2025 Q1–Q4 · 0 split decisions excluded

Provider win rate

96.6%

n = 88 · 2025 Q1–Q4

Median payment vs QPA

27.45x †

middle half 6.50x–131.28x · n = 86 · 2025 Q1–Q4

Median days to decision

26

business days, from dispute initiation · n = 88 · 2025 Q1–Q4

Dollar amounts are not shown for specialty groups: the CMS QPA and Offers file, the only source of dollar figures, has no specialty field. See methodology.

By period

PeriodLine itemsWin %Median ×QPA25th–75thRatio nMedian days
2025 Q1–Q48896.6%27.45x †6.50x–131.28x8626
2024 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–Q4Fewer than 30 determined line items; not shown.
2023 Q1–2025 Q412696.8%6.96x4.17x–60.15x124not pooled

Line items = determined dispute line items (n). Win rate excludes split decisions and includes default decisions. Ratio n = line items reporting a payment-to-QPA ratio. Days are business days as reported by CMS (2023–2024: from IDR entity assignment; 2025: from initiation) and are never pooled.

Most disputed CPT codes

No row has 30 or more determined line items in 2025 Q1–Q4.

Related: all specialties in New Jersey · Critical care in all states

FAQ

What is the Federal IDR provider win rate for critical care in New Jersey?

In 2025 Q1–Q4, the provider or facility offer was selected in 96.6% of 88 determined dispute line items for critical care in New Jersey. Split decisions are excluded from the denominator and default decisions are included. Withdrawn, settled and ineligible disputes are not in the CMS data.

How do Federal IDR payments compare with the QPA for critical care in New Jersey?

In 2025 Q1–Q4, the median prevailing offer was 27.45x the qualifying payment amount (QPA), with a 25th to 75th percentile range of 6.50x to 131.28x (n = 86 line items). This uses the CMS field Prevailing Party Offer as % of QPA, where 1.00x equals the QPA.

How long do Federal IDR decisions take for critical care in New Jersey?

In 2025 Q1–Q4, the median was 26 business days (n = 88 line items), using the CMS field Length of Time to Make Determination (from dispute initiation).

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